Of Madness and Guilt
by Mistress Sorcha
Summary: Something isn't right with Dean. He's not himself. When Sam returns to find Dean, who seemingly believes Sam is dead and he was the one who killed him, laying bleeding and dying...he fears his inaction may have let Dean go over the edge into madness...


**Warning:** Sick/Insane/Hurt!Dean, Worried/Protective!Sammy and Bobby.

**Disclaimer:** I do not own Supernatural, the boys, or our dear Bobby...Friggin Kripke doesn't like to share...he owns all my toys, damn him....

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**Chapter 1:**

**Desolation **

Sam huffed out a quiet breath, looking down at his watch…he'd been gone for a couple hours, he hoped against hope that his brother had slept the whole time…Dean hadn't been himself for a while. He had been quiet…even more closed-lipped then usual…his brother hadn't said ten words to him today, if that. He slept fitfully, even more so then usual. Sam knew something was wrong, but he couldn't put his finger on what just yet. He had gone to the library to do what he did best: research…he hadn't found anything specific to suggest what was going with his older brother…

He clapped the book closed and sighed, rising slowly to allow his body to adjust itself into some semblance of normal, his joints creaking noisily as he twisted at his torso to ease the aching pressure in his back. When he was satisfied he could walk again, he turned and levered he jacket up off the back of the chair and tucked his lengthy limbs into its sleeves. Retrieving his laptop and notebook from the table, he ambled his way softly across the vast space and out into the stark contrast of the street outside.

The quietude of the library was wiped from his mind in mere moments by the cacophony of the bustling street. He shook his head softly in amusement and struck out down the street toward the motel he and Dean were staying at. He stopped along the way to grab up some food, opting for Dean's favorite burger and fries combo and a chef's salad for himself. He shifted his packages and laptop case to dig the key from his pocket, frowning slightly when it got stuck inside briefly…he winced slightly, sure he had heard a tearing noise as he finally pulled it free…he groaned, mumbling his complaints of now having something else to repair softly under his breath.

He tipped the door shut behind him with his boot tip and walked the 3 steps, well 3 with his long legs, toward the table by the window…the dim light of dusk shone hazily through the gap in the curtains, though it was too dim to see anything past a foot or two before him. Sam set the laptop and notebook down, then set the food across from it, he turned around finally to flick his long fingers over the switch-plate and the room was suddenly blooming with the bright haze of the bare bulb at the center of the room. He turned toward the bed and frowned…the rumpled covers bore no prone body in the shape of Dean…he knew the Impala was still in the same spot outside, so his brother had to still be here, unless maybe he took a walk…Sam hrmpfed softly then caught the edge of his bottom lip between his teeth as he struggled to dig his long fingers into his jean pocket for his phone…he had just got it out and flicked open when he heard a voice, the mumbled words incomprehensible at this distance. He cocked his head to the side, tipping his ear toward the voice, only able to hear one word: 'Sammy'...His worry ratcheted up exponentially as his eyes widened and he hurried around the edge of the bed and past the other bed toward the bathroom. It was there he found his missing brother. He stood aghast and unmoving at the sight that greeted him,

Dean sat on the filth-coated, tiled floor of the bathroom, rocking back and forth, knees tucked under his chin, arms tucked in between his torso and thighs, words tumbling ceaselessly from his pale lips…tear tracks shone wetly on his cheeks…his eyes wild and unfocused…the thing that made Sam gasp in terror was the welling pool of blood surrounding his brothers rocking form…

Sam dropped to his knees, gripping his brother's shoulders tightly, shaking and calling to him…but there was absotlutely no response…"Dean!!! Dean, please, man!!!! Tell me what's wrong!!!!!" Sam cried loudly, shaking him harder…Dean's eyes shifted to his and he crawled backward in terror…

"You're not him!!! You're not Sammy!! I killed Sammy!!!! I killed you!!! You're not real!!!!...." Dean screamed shrilly before he broke off into whimpering cries…mumbling the same thing over and over again…his arms flailed wildly as Sam tried to get a hold on him…he gripped at his brother wrists, confused for a moment when his fingers couldn't find purchase around them… they slid around erratically, slipping and sliding as he tried to hold on. Sam jerked them forward, understanding the reason why when he got a good look at them…

Long, terrible wounds sliced deeply up and down the length of his brothers forearms…blood pumped weakly from them, cascading down from the elbows to drip and pour onto the floor…His brother fought him still, trying to wrench himself out of the grasping hands, but to no avail. Dean listed limply, his fight leaving him as the blood poured out of his body. He slumped slowly toward the floor, his body limply colliding with the blood-coated tiles…

"DEAN!!!!!!!!!!!!!!!!!!! Dean, no!!!" Sam screamed, shaking his brother's shoulders, tears pouring from his eyes as he fumbled behind him for a towel. He torqued it free of the bar it hung from, tearing it into two long strips of cloth…

"Dean, please don't do this to me…please…you gotta stay with me…" Sam whispered desperately as he wrapped his brother's wrists tightly. His brother's body jerked softly, the light slowly leaving his eyes…his breath slowed and stilled altogether…

"No….no no no no……please….Dean…." Sam's head hung low, whimpering cries for his brother falling from his lips…his whole body shook at the sight of his brother's still form. His breath caught in his throat. He swallowed harshly. No, he was not going to let this happen, dammit! He flipped open his phone and dialed 911, setting it on speaker phone he placed on top the closed toilet lid as he drug his brother down and positioned his hands over his brother's sternum, pumping his chest with quick, sure thrusts. He heard the phone click over and the operator pick up on the other end of the line…

"911, please state the nature of your emergency?" the professional-sounding feminine voiced issued from the phone…

"Please help me!!! My brother isn't breathing and he's lost a lot of blood!!! You gotta send an ambulance!!!! Please!!!!" Sam screamed toward the phone...he stilled his pumping to tilt his brother's throat back and puff quick breaths into him before he resumed pumping at his chest again…

"Sir? I need to know your location…" the voice sounded from the phone…

Sam, panting in effort, turned toward the phone briefly to dispel their location to the operator…"Ok sir, we have an ambulance on the way…you said your brother isn't breathing, are you attempting resuscitation?"

"Yes!! He's still not breathing!!! I'm doing the chest compressions and the breathing…I can't find a pulse….Hurry!! You gotta hurry!!!" Sam cried out, the desperation ringing heavily in his voice…

"Sir…what's your name?

"Sam…" he panted out, breaking off to dip down and breathe into his brother's slack lips again before continuing compressions…. "Dammit Dean….come on man!! Breathe, damn you!!!! Breathe!!!!!"

"Sam, I need you to continue attempting resuscitation until the rescue unit arrives, ok? As long as the blood is being pumped in his system and you breath for him, he stands a better chance of being resuscitated….The ambulance should be there soon…just hold on, ok?" the women's calm voice worked to try to soothe his frayed nerves. Sam closed his eyes for a moment and swallowed, willing himself to keep going, then a thought caught in his mind. Words that the operator had said started stirring something in his mind. Blood…pumping…blood…his mind worked frantically. He knew the demon blood Ruby gave him let him heal quicker…what if it could do the same for Dean?…He made up his mind rapidly, becasue if he was being honest with himself, he had nothing left to lose at this point…

"Sam? Are you still there?" the operator asked…

Sam dug into his back pocket, grasping the folded knife from its usual home there…he popped open the button at his wrist and wrenched back the cloth there…."Yeah…still here…" he said in the general direction of the phone…he bit his lip sharply, gasping in a breath as he slid the blade across the flesh of his wrist, a short, narrow line that horribly mimicked Dean's wounds…he placed his wrist to Dean's lips, his other hand moved in pressing, squeezing strokes up from his elbow to just below the wound, pushing the blood out of the wound and into his brother's mouth in long, throbbing spurts…he let the blood pour down his brother's throat…Sam winced, sucking in breaths. He looked at the wound, noticing that it was merely trickling now. Dammit, he thought as he gripped the knife and brought it down, sweeping over the flesh again, letting the heavy gushes of blood pour into Dean's lips. When the wound began to trickle off once again, he let it this time. He knelt at his brother's side and began chest compressions again, forcing the blood to pump in Dean's veins. He alternated through two more rounds of breaths and compressions before he heard the pounding at the door. Sam bolted upright as he ran to open it and let the emergency workers inside. He ran before them, leading them to his brother's body…

"How long has he been down?" the stocky, dark-haired man asked out loud…

Sam tipped his watch toward himself…"Um…about 15 minutes…maybe a little more…." He said, still panting from the strain…

The dark-haired man exchanged a look with his blonde-haired companion, but they continued to work any way…they always did, in the presence of family and such but they held little hope for the man they administered to. They lifted him bodily onto the stretcher, securing a mask over his face. They rolled him out and hoisted him into the back of the waiting ambulance, the dark-haired man tipped his head to speak into the mic at his shoulder. "This is first responder Adam 1, we are rolling hot with a patient, male, late 20's/early 30's, patient has no discernable pulse, he is not breathing on his own…patient has 2 wounds, one on either arm from wrist to elbow. Patient has suffered heavy blood loss…" he said, as he examined the wounds briefly before packing gauze over them. He broke off, turning his attention to the other man…"You wanna ride with us or follow behind in your own vehicle?" he asked the young man that watched him anxiously as his partner continued working on the patient just behind him…

"I wanna ride with you…I can't…I won't leave him…he's my brother…just…let me get my phone.. " he said sprinting to bathroom and retrieving it…"Miss…" he said into the line as he clicked it off speaker phone…

"Jessica, but please….call me Jess." She said softly.

Sam closed the door to the room, his breath hitching in his chest at the name of the woman on the other end of the line. He swallowed hard, pushing down the memories of his own Jess before he bounded to the ambulance, levering himself up into the cab to sit beside his brother. The dark-haired man closed the door and the blonde man tapped the wall of cab and the ambulance ambled out into the street, cruising rapidly toward the hospital "Jess, thank you…the ambulance is here and they have my brother loaded up and we're heading to the hospital now…thank you…thank you so much….I better get off the phone now…"

"Ok Sam. I understand…Sam? "

"Yes?"

"Would it be alright if I pray for you and your brother? " she said softly…

"Yeah, that would be alright…I think we could use all the help we can get…Thanks again, Jess…goodbye…" he said quietly as he flipped the phone closed. Sam buried his face in his hands as his tears started afresh. He pushed back the tears as he swiped him palm over his face before reaching out to take his brother's hand…

They had a tube in Dean's throat now, the blonde man was steadily pumping the bag to press air into his brother's lungs. The dark-haired man paused compressions to inject something into his brother's arm before he tipped his head toward the mic at his shoulder again. "One amp of Epi administered en route, patient has been down for 22 minutes, be advised patient is still not breathing, nor is there a pulse present…attempting paddles, hold…" he broke off as he slid scissors under the cloth of the man's shirt, flipping back the edges of the material and discarding the scissors…he placed the pads down on the patient's chest, activating the machine. He squeezed the gel pack on the paddles and let the machine ramp up, scanning as it built in power…

The hollow, computerized voice sounded in the cab… "Scanning….no pulse-rate detected….shock advised….please place paddles on indicated locations…" it said as it's display lit up to show correct placement. The dark-haired man placed paddles as directed, and placed a finger over the button, waiting for the command from the machine. "Assure the patient is secured and all personnel are clear before depressing green button to administer charge…." The dark-haired man nodded to the blonde man, who stood back. He turned to Sam. "Gonna have to ask you to let go for a minute, and sit back, ok?" Sam nodded and did as he asked. He watched as the man hit the button and Dean's body arched off the stretcher, straining against the restraining straps harshly before finally settling back down. The machine sounded out again. "Scanning….no pulse-rate detected…shock advised…15 seconds until full power available…" the machine droned out…

Sam reached out and grasped his brother's hand briefly, squeezing hard…"Come on Dean….please…don't do this…" he choked out. He felt the dark-haired man's hand on his shoulder and turned to look at him…he nodded and reluctantly pulled his fingers from Dean's grasp.

"Charge level achieved…administer shock…" the man hit the button again after checking everyone was clear…Dean's body jolted hard against the restraints, collapsing back limply to the stretcher's surface…"Scanning…no pulse-rate detected…" the man shook his head as he flicked off the machine…he knew it had been a long shot to begin with. He tipped his head to the mic again. "Patient down for 31 minutes…Shock unsuccessful…calling Code Black at…" he tipped his wrist to look at his watch to assign an official time of death…Sam buried his face in his hands, rocking back and forth…his brother was dead…again… gone…by his own hand…

Before the man could speak the time into the mic, Dean's body arched violently…Sam's eyes flew open as his brother tried to suck in air, choking on the tube in his throat…his eyes fluttered open and closed for a moment before clamping shut again and he collapsed back onto the stretcher…"Holy shit!!" the dark-haired man cried out…he turned the machine on again… "Scanning… pulse-rate detected…." His eyes were wide with amazement…he'd never had someone come back after being down so long…"Be advised! Cancel Code Black…patient has been revived! Pulse is rapid, breathing erratic, but leveling out…" Sam grasped Dean's hand, tears pouring harder as he watched the rise and fall of his brother's chest…

"Dean!!!! Thank God!! Dean…hang on, man!!!! Jesus!! You scared the shit out of me!!!!" Sam cried out, gripping his brother's hand like he was hanging over a cliff about to fall…

The ambulance rolled into the hospital's emergency bay. The dark-haired man threw open the door and the waiting crowd of nurses and doctors helped bring the stretcher down to the ground and wheel it toward the sliding doors. Sam jumped down and followed his brother into the hospital…

"Sir, you are going to have to wait in the waiting room…" a nurse said as she tried to pull him gently out of the room…

"No!!...I am not leaving my brother alone…" he said as he stood beside his brother and gripped Dean's hand tightly in his own…

The nurse looked at the doctor. He looked upon the young man. From what he could see, the young man looked like he would break under the strain if he was made to leave. He knew it was against protocol, but he had a brother and he knew how he'd feel if he were in the same position, so he nodded to the nurse… "It's ok Muriel…let him stay…"

Sam looked at the doctor, thanking him silently with his tear-filled eyes before turning all his attention back to his brother. The nurses fairly flew around him, hooking up equipment, and piercing his brother's arms with needles, placing junctions for IVs and tubes for blood and plasma, attaching probes to monitor his condition. The doctor called for space in the ICU, waiting until the patient stabilized enough to be moved. He strode over to the young man, laying a gentle hand on his shoulder…the man turned to look at him.

"Son…your brother's condition has stabilized enough to move him to the ICU…we're gonna take real good care of him for you now, ok? Now I need you to let go, just for a little while. When we get him set up in his room, then you can go be with him, ok? Now, why don't you come with me so I can have the desk nurse get you started on the paper work. I promise, you won't be away from your brother for more then a little bit…" he said gently, letting the man process his words…

Sam looked at the older man eyes, letting his words sink in. He gulped in a shaky breath and nodded…"Ok…" he said softly, reluctantly as he let go. His brother's hand slid from his as they wheeled him away. The older man guided him to the front desk and the kind-eyed woman there handed him a clipboard with a stack of info and paperwork…"Um…we don't have any insurance…we're kinda between jobs right now…" Sam said quietly…

"Do you have a credit card?" she asked…

"Yeah…who doesn't these days…" Sam said, trying to decide which name to use and trying to remember which card that name was on…

"Ok, then you should be fine with that…there is information in the packet about indigent care are how to apply for funding for that…Do that as soon as you can so they can get started processing, ok?" she said. Sam nodded and went to sit, hurrying his way through the paperwork…he returned to the desk and handed the woman the packet and his card…she input the info in the computer, checked the card and handed it back, to Sam. "Ok, if you wanna take a seat until the doctor comes to get you…maybe if you have family…now would be a good time to call them…." Sam nodded and went to sit down…

He pulled out the phone and stared at it for a long time before flipping it open and scrolling down to Bobby's entry. Sam thumbed the send button and waited for Bobby to pick up on the other end. After what felt like an eternity, Bobby picked up the line, his gruff voice sounding over the phone…"Hello?"

Sam choked, his emotions threatening to overwhelm him again…"Bobby…" he managed to get out.

"Sam? What's wrong, son?" He said, his voice softening with concern…

"Bobby…it's….it's Dean….he's…" he choked again, he swallowed hard, making himself go on…" God….Bobby…there was so much blood…he was d-ddead for 30 minutes…before they brought h-himm back…" Sam broke off in a heaving sob, burying his face in his hand…

"Sam….hold on son…I'm coming to you… I need you to tell me where you are…" Bobby said, trying to soothe Sam's worries and his own. Sam told him the name of the hospital and the city they were in.

"Ok. Sam…I'm about a 6 hour drive away…just stay there and I'll be there as soon as I can. Hold on, son…I'm coming" Bobby said as he prepared to leave.

"Ok Bobby…I'll be waiting. Thanks…" Sam said as he hung up the phone…he lowered his head, silently praying for Dean… willing himself to hold on until Bobby got there. He felt a gentle, firm hand on his shoulder and he turned to look up and saw the face of the older doctor looking down at him.

"You can go on up, son. He's in room 340…third floor. Ok? I already instructed the nurse to bring in a recliner for you so you can stay in the room with your brother."

"Thank you, Doctor…"

"Jensen. Jack Jensen. And I'm sorry, I just realized I don't know your name either…" the older man said cordially as he reached out his hand toward Sam.

"Sam…Sam Weston. Thank you for everything you've done for me and my brother, Dr. Jensen." Sam said, grasping the man's hand in a firm shake.

"You're quite welcome, Mr. Weston. Go on and get up there. I know you're itching to go see your brother. I'll instruct the nurse to grab you some scrubs to change into until you can get your own clothes taken care of..."

Sam smiled gratefully for a moment, before looking down at himself. He was covered in Dean's blood...He swallowed heavily at the thought and nodded, thanking the kind doctor before he turned and quickly made his way to the elevator. Once the doors slid open to the third floor, he stopped at the desk and got directions to his brother's room. The nurse set down the phone, telling him to wait there for a sec. She went a short distance down the hall, disappearing into a room behind a closed door. She reappeared soon thereafter, a neat stack of scrubs in her hands. "Here you go. Doctor Jensen phoned and asked me to lend these to you." Sam nodded politely and took the offered clothes. He turned and made his way down the hall and opened the door, slipping quietly into the room. Sam choked back a sob as he looked upon the still form of his brother. They had cleaned the blood from him and had bandaged up the wounds. Dean was swallowed up in a nest of wires and tubes. Sam worked hard to hold it together. He quickly shucked of his blood-drenched clothes. He folded them and piled them in a corner where he wouldn't have to look upon them and be reminded of the horrible point in time that had caused them to be in their current condition. He slipped into the too-short scrub pants and slightly snug shirt. Once done, Sam pulled the waiting recliner closer and took his place by his brother's side. He reached to grasp his brother's limp hand as he watched the steady rise and fall of his chest. The mess of leads and tubes and tape made Dean almost unrecognizeable. Sam couldn't help it any longer. He broke down in racking sobs, tears flowing unabated. He couldn't believe he'd almost lost his big brother again, this time closely mirroring the last with his ravaged body and the welling pool of blood surrounding him. The memories of the last time brought a surge of horror and sadness as he remembered how lost and alone he had been without his big brother there to guide him..

"Dean..." he whispered in a desperate sob. "Why, Dean...why?..." he said in bitter quietude, his tearing eyes shifting shut as he lay his head down by his brother's arm, all the while, the unanswered question rang terribly in the hollow emptiness of the room.


End file.
